Laparoscopic sacral colpopexy: Pearls and pitfalls

Abstract

12. Laparoscopic Sacral Colpopexy: Pearls and Pitfalls V Sabella, C Gonirna. Lone Star Ob/Gyn Associates, San Antonio, Texas. Study Objective. The incidence of posthysterectomy vault prolapse has been reported between 0.2% and 1% on symptomatic patients. By physical examination, the incidence is 4.4% overall, and up to 11.6% if the hysterectomy was done for prolapse. As of this writing, the best corrective procedure has been sacral colpopexy with a reported success rate ranging from 93 % to 99%, far superior to sacrospinous ligament fixation with reported success rates from 65 % to 85 %. Multiple reports have shown the equivalence of success rates between laparotomy and laparoscopic approaches for sacral colpopexy. Desigrz. We present 21 laparoscopic sacral colpopexy procedures. In 17 cases, a polyester aortic vascular graft was used. Acellular porcine dermis was used in 3 cases and direct stitching of the vaginal cuff to the promontorium of the sacrum was done in one case. Ma#z Result. The procedure failed in two cases (9.5%). In one patient no graft was used. Excluding this case from our series, the overall success using grafts 95.2%. Corzclusiorz. We stress the importance of using a graft material, preferably of cylindrical shape, in all cases of sacral colpopexy.